Cancer Causes & Control

, Volume 21, Issue 7, pp 1033–1046 | Cite as

Intake of fiber and nuts during adolescence and incidence of proliferative benign breast disease

  • Xuefen Su
  • Rulla M. Tamimi
  • Laura C. Collins
  • Heather J. Baer
  • Eunyoung Cho
  • Laura Sampson
  • Walter C. Willett
  • Stuart J. Schnitt
  • James L. Connolly
  • Bernard A. Rosner
  • Graham A. Colditz
Original paper



We examined the association between adolescent fiber intake and proliferative BBD, a marker of increased breast cancer risk, in the Nurses’ Health Study II.


Among 29,480 women who completed a high school diet questionnaire in 1998, 682 proliferative BBD cases were identified and confirmed by centralized pathology review between 1991 and 2001. Multivariate-adjusted Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).


Women in the highest quintile of adolescent fiber intake had a 25% lower risk of proliferative BBD (multivariate HR (95% CI): 0.75 (0.59, 0.96), p-trend = 0.01) than women in the lowest quintile. High school intake of nuts was also related to significantly reduced BBD risk. Women consuming ≥2 servings of nuts/week had a 36% lower risk (multivariate HR (95% CI): 0.64 (0.48, 0.85), p-trend < 0.01) than women consuming <1 serving/month. Results were essentially the same when the analysis was restricted to prospective cases (n = 142) diagnosed after return of the high school diet questionnaire.


These findings support the hypothesis that dietary intake of fiber and nuts during adolescence influences subsequent risk of breast disease and may suggest a viable means for breast cancer prevention.


Adolescent diet Fiber Nuts Proliferative BBD 



This study was supported by the National Institutes of Health Public Health Service Grants CA046475, CA050385, and CA089393, and Breast Cancer Research Foundation. Dr. Graham Colditz is supported in part by American Cancer Society Cissy Hornung Clinical Research Professorship.

The work was performed at Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts.

We thank the Nurses’ Health Study II participants for their dedication to this study.


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Copyright information

© Springer Science+Business Media B.V. 2010

Authors and Affiliations

  • Xuefen Su
    • 1
    • 2
  • Rulla M. Tamimi
    • 1
    • 2
  • Laura C. Collins
    • 3
  • Heather J. Baer
    • 2
    • 4
  • Eunyoung Cho
    • 1
    • 5
  • Laura Sampson
    • 1
    • 5
  • Walter C. Willett
    • 1
    • 2
    • 5
  • Stuart J. Schnitt
    • 3
  • James L. Connolly
    • 3
  • Bernard A. Rosner
    • 1
    • 6
  • Graham A. Colditz
    • 2
    • 7
  1. 1.Channing Laboratory, Department of MedicineBrigham and Women’s Hospital and Harvard Medical SchoolBostonUSA
  2. 2.Department of EpidemiologyHarvard School of Public HealthBostonUSA
  3. 3.Department of PathologyHarvard Medical School and Beth Israel Deaconess Medical CenterBostonUSA
  4. 4.Division of General MedicineBrigham and Women’s Hospital and Harvard Medical SchoolBostonUSA
  5. 5.Department of NutritionHarvard School of Public HealthBostonUSA
  6. 6.Department of BiostatisticsHarvard School of Public HealthBostonUSA
  7. 7.Alvin J. Siteman Cancer Center and Department of SurgeryWashington University School of MedicineSt. LouisUSA

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